Altering the route of delivery
- Injecting oral formulations
- Crushing Oral formulations
Accessing opioids from other sources
- Taking drugs from family or friends
- Buying prescription medications from the street
- Multiple-doctoring
Drug seeking
- Recurrent prescription losses
- Ongoing complaints about need to increase dose
- Asking for specific medication
Presenting with withdrawal symptoms
- Dysphoria
- Myalgias
- Diarrhea
- Cravings
- Sweating
- Goosebumps
Concurrent disorders
- Alcohol dependence
- Stimulant abuse
- Cannabinoids abuse
- Mood disorders resistant to treatment
- Anxiety disorders resistant to treatment
Social instability
- Family and relationship problems
- Job loss and unemployment
- Concerns expressed by family or friends
Personal believes
- Resistance to dose reduction
- Reporting severe withdrawal symptoms with minor dose reduction
- Denying dependence